Umbilical cord mesenchymal stem cells for the treatment of refractory chronic graft-versus-host disease / 中国组织工程研究

ABSTRACT

BACKGROUND: Chronic graft-versus-host disease is the most common complication after transplantation and glucocorticoid is a first-line drug. Glucocorticoid in combination with immunosuppressive therapy is not effective in half of the patients with hormone resistant chronic graft-versus-host disease. The low immunogenicity of umbilical cord mesenchymal stem cells provides the possibility for clinical treatment of graft-versus-host disease. OBJECTIVE: To investigate the clinical efficacy and safety of umbilical cord-derived mesenchymal stem cells to treat refractory chronic graft-versus-host disease. METHODS: Fifteen patients with refractory chronic graft-versus-host disease received mesenchymal stem cell infusion treatment based on immunosuppressive therapy. The therapeutic efficacy, infusion-related adverse reactions, and survival were analyzed. The ratio change of peripheral blood lymphocytes was determined by flow cytometry. This study was approved by Medical Ethics Committee, Third Affiliated Hospital of Sun Yat-sen University in China. RESULTS AND CONCLUSION: There were 12 male and 3 female patients with a median age of 29 years (ranging from 17 to 52 years). Four patients obtained complete response, seven patients obtained partial response, 11 had overall response, and four patients had no response. After treatment by umbilical cord mesenchymal stem cells, the ratio of CD19+ cells in the peripheral blood was slightly, but not significantly lower, but CD19+ CD27+ and CD3+ cell ratios were slightly, but not significantly higher than those before treatment. No patients had adverse reactions related to infusion of umbilical cord mesenchymal stem cells and no patients had primary disease recurrence and mesenchymal stem cell-related tumor. These findings suggest that umbilical cord-derived mesenchymal stem cell infusion is an effective and safe therapy for refractory chronic graft-versus-host disease.